Permit CITY OF TIGARD MECHANICAL PERMIT
?� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00096
' �f �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/10/2005
PARCEL: 2S 103BA -00144
SITE ADDRESS: 11970 SW LYNN ST
SUBDIVISION: LERON HEIGHTS NO. 2 ZONING: R -4.5
BLOCK: LOT: 028 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Replace furnace.
Owner: FEES
STEVE STEVENSON Description Date Amount
11970 SW LYNN ST [MECH] Permit Fee 3/10/200f. $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 3/10/200f. $5.80
Phone: 503 - 590 - 4141 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 538 - 2953
Reg #: LIC 125815
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You
may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699.
Issued By i� . Permittee Signatur
Call (503) 639 .4175 by 7:00 P.M. for inspections needed the next business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mar 09 05 12:29p 503- 537 -2172 p.2
Mecha111ical Permit Application FOR OFFICE USE ONLY
C�
City of T' 1. rd Received .
Pla i Penat t No.: NECa40s — ono/ ,
13125 SW Hall Blvd., Tigard, OR 97223 n Review
�� "- "- �
Phone: 503.639.4171 Fax: 503.598.1 if G 1v E D ,` „r5,• L - Plan R DateB rncw
Other Penult:
Line: 503.639.4175 R - a 11 -• I Date ReadyBy: win V23 See Page 2 for
Internet: www.ci.ligard.or.us 2 05 Notified/Method: Supplemental Information
' ~
.0*. OF ; k :SCE — [j$ C.Kf.i$
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❑ New construction y e Atel1Toii1/2Iament Mechanical permit fees' are based on the value of the work
D1 CJT° t performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ g- mechanical materials. equipment, labor, overhead, and profit.
•... .... •
_ .,
- ... . •:::.:. CATE0�3C :;OFCUIQSTRQ3!1::;'!:;:;: � �a
:_ 4 ENThL- f 'MENT / 'STEMS )N ± • . .
1 - and 2- family dwelling ❑ Commercial/industrial Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. 1 Ea. I Total
:::: .... ... :: 44 1 $: , 5 r 1 �.` *O0IE4' 0 ANDF:cic?> TIQNi :`: ?; HeatinP/coollnR
Job site address: r Air conditioning or heat pump
�, -r,i/ �' (requires site plan showing placement) 14.00 I L
' Furnace 100,000 BTU (ducts/vents) f 14.00
as 3
City /State/ZIP: 8 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name: Gas heat pump 14.00
-
Cross strect/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
............ .
_ ....... ... .. _ • .....,. D �i�' -�'' _ - Water heater
R.,,t40
,:.•_..:. .:._.. ESCt2>CPTlfd� _ ORIC`__: "., = `�_''S.:. �
Gas fireplace 10.00
//III V � Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
r y/liner/flue/vent 10.00
Nam ' 1 Environmental exhaust and ventilation
Address: 112_,
1 fl D Range hood/other kitchen
equipment 10.00
City/Sta /IAA , r ' _ 1 a; ,-- 3 Clothes dryer exhaust 10.00
te/ZIP
' Single -duct exhaust (bathrooms,
Photo) Uf1 �,�� Fax: ( ) toilet com artments, utility moms) 6.80
�,..: P.LICAlitit';:::. ,... * .. Attic /crawlspace fans 10.00
...:...................
1O rlll<!'iI1>:7t1II �_� .� , . i IA Fuel piping
10.00
Contact name: IP ri K7 1 — $5.40 for first four; $1.00 for each additional
Address: ,gip 6_,, Furnace, etc.
Gas heat pump
City /StatcrLIP: / I V 0 q l i( Wall/suspended/unit heater
Phon . b • : / 1d. Fax . , l ` ) 41 r 44 Z Water heater
— • Fireplace
E -mail: Range
..
CTO
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;.:::::; i':" ii :� :
; :: 9i ' Barbecue
Business nam : ,,, _l.: i� R ._ • I A./ iii Clothes dryer (gas)
, Other:
Address: /3 ` { I11 i is : ; :.,,,. .
�. v ___ ' / ........_..... : . . .. . ... . .....�'f.. �IC4xPmA1'ilF1t0 :. ..
City /State/ZLP: i
o r l I Subtotal J
• Minimum permit fcc ($72.50)
Phone I - 4 — F ) `S' Z.. plan review (25% of permit fee)
CCIB lie.: ( C/ G') 4 l c State surcharge (8% of permit fee)
■ TOTAL PERMIT FEE — 1
Authoriz s'gnatur� �, 4„,,,_ ,, `. This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete.
�_'� M I 71 2I , I 1101 1 37 ` Date: WHIM' • Fee methodology set by Tri- County Building Industry Service Board
is5uddi „gWe,n,itA.MI:C- Per,,,ilApp.duc 12/03 40-46177 (11 /02/COM/W013)
CITY OF TIGARD
BUILDIN6 DIVISION PERMIT #: MEC2005.00096
13125 SW HaII�Blvd., Tigard, OR 97223 D ATE ISSUED: 3/10/2005
Phone: (503) 639 -4171 ui a� l l l ,l
Inspection Requests (24 Hrs.): (503) 639 -4175 a `__ '
INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7:14AM PAGE: 115
SITE ADDRESS: 11970 SW LYNN ST CLASS OF WORK:
SUBDIVISION: LERON HEIGHTS NO. 2 LOT #: 028 TYPE OF USE:
PROJECT NAME: STEVENSON
DESCRIPTION: Replace furnace.
OWNER: STEVENSON, STEVE PHONE #: 503 - 590 -4141
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 538-2953
Inspection Request Scheduled For: Date: 4/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 003876 -01 503. 538.2953 N
Corrections /Comments /Instructions:
P ❑PARTIAL APPROVAL ❑ CANCEL
CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: -4- - 7 —BS Phone #: (503) 718-